If you are a
licensed professional and you require CE credits to
maintain your license and your licence is current we
will accept that you have met the CE requirement to
maintain your designation.

If you are in a profession that does not require you to maintain
Continuing Education credits you will not require formal Continuing
Education confirmation to renew your EPC membership.

PLEASE DO NOT USE ALL CAPITAL
LETTERS

STEP 1 - Please enter
your personal information

Your Name:

Company:

Mailing address:

City:

Province:

Postal code:

Is this a"NEW"address?
YesNo

Business Phone:

Ext:

Home Phone:

Cell Phone:

Fax:

E-mail Address:

Do you have any"NEW"Designations
or certifications that we do not know about?
Yes No

If Yes - what
are they?

SINCE YOUR LAST RENEWAL

Have you been convicted of a Criminal Offence for which
you have not been granted a pardon?
NO
YES

Have you
been disciplined or had any restrictions placed on any
professional licence that you hold by any Regulatory Body
or Association? NO YES

STEP 2 - Education
Certification * Only applies to an individual who is licensed

By initializing below I
hereby certify that I have attained 30 continuing education credits
this renewal period.

Please type
your initials hereif
applicable

PLEASE NOTE-
At the time of renewal you will not be required to submit any CE
supporting documentation. CIEPS relies on the accuracy of the EPC
Professional's self-assessment of their CE activities. Therefore,
you willONLYbe
required to submit your CE supporting documentation if you are
selected in the random audit.

* Your requirements for renewing your EPC Designation
If you are a licensed professional and you require CE credits to
maintain your license and your licence is current we will accept
that you have met the CE requirement to maintain your designation.If you are in a profession that does not require you to maintain
Continuing Education credits you will not require formal Continuing
Education confirmation to renew your EPC membership.